Nadine M. Tung, MD
Director, Cancer Risk and Prevention Program
Beth Israel Deaconess Medical Center
Associate Professor of Medicine, Harvard Medical School
Beth Israel Deaconess Medical Center
Determining which patients with early-stage, BRCA-driven breast cancer respond best to chemotherapy.
The BRCA1 and BRCA2 genes are the most commonly mutated genes in hereditary breast and ovarian cancers. Normally, BRCA 1 and BRCA2 function to ensure the proper repair of DNA damage, but mutations in these genes lead to rapid accumulation of DNA errors, which is the underlying cause of cancer. However, this defect also makes BRCA-mutated cells vulnerable to treatments that cause DNA damage. Cisplatin, a chemotherapy agent not typically used to treat breast cancer, had demonstrated good activity in BRCA mutation carriers with breast cancer and in some women with triple-negative breast cancer (TNBC). Recently, Drs. Tung and Schnitt completed the INFORM trial, which showed that while cisplatin is an active agent in BRCA mutation carriers with breast cancer, it was not more effective than the standard chemotherapy regimen. Drs. Tung and Schnitt are evaluating why some breast cancers respond to chemotherapy, including platinum chemotherapy, and other breast cancers do not.
As part of the INFORM clinical trial, clinicians collected valuable biopsies as well as blood samples. Drs. Tung and Schnitt are now analyzing the samples to identify biomarkers that are predictors of chemotherapy and/or cisplatin response or resistance in BRCA mutation carriers with breast cancer. Although this work is being conducted in breast cancers that developed in women with inherited BRCA1 and BRCA2 mutations, the results will inform the behavior of breast cancers in women without these inherited mutations, including patients with TNBC and estrogen receptor-positive breast cancer.
In the upcoming year, Drs. Tung and Schnitt will proceed with analysis of the tumor and blood samples collected as part of the INFORM trial. The samples provide a unique and valuable cohort to assess the molecular landscape of hereditary breast cancers and to find biomarkers of tumor growth and of response or resistance to chemotherapy. This will be the largest cohort of breast cancers from BRCA mutation carriers to undergo such extensive molecular analyses. In addition, the team also plans use artificial intelligence to analyze tumor samples. Using these images, they are working to develop an algorithm to identify those patients likely to respond well to treatments.
Nadine Tung, MD is the Director of the Cancer Genetics and Prevention Program at Beth Israel Deaconess Medical Center (BIDMC) which she established in 1997 to evaluate patients and families with hereditary cancer syndromes. She is also a breast medical oncologist and a member of the Dana-Farber Harvard Cancer Center as well as an Associate Professor at Harvard Medical School. She graduated from Princeton University in 1980 and Harvard Medical School in 1984.
Dr. Tung's research focuses on hereditary causes of breast cancer as well as effective strategies for breast cancer prevention and treatment. Much of her research has focused on women with BRCA1 and BRCA2 mutations, studying the genetic and environmental factors that influence cancer development as well as the biology and prognosis of the breast cancers they develop. Through BCRF, she is overseeing a multi-center, national trial evaluating whether cisplatin is superior to standard chemotherapy for women with BRCA1/2 mutations and newly diagnosed breast cancer. Her research also focuses on identifying other inherited gene mutations that predispose to breast cancer. Other areas of Dr. Tung’s research include evaluating the prognosis and optimal treatment of triple- negative breast cancer. Dr. Tung serves on the Editorial Board of the Journal of Clinical Oncology as well as the American Society of Clinical Oncology’s Cancer Prevention Committee and Cancer Genetics Subcommittee.
The Joan Lunden Award
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